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P. Cech and J. Luptak

Abstract

Objective: The aim of our study is to evaluate complications In patients who underwent a Transrectal Ultrasound Guided Prostate Biopsy (TRUS BP) at the Department of Urology of JFM CU and UHM in 2007-2008 and at the Department of Urology in Bojnice Hospital in 2009-2012.

Methodology, disclosures: In our study, patients with positive digital rectal examination (DRE) and/or with hig- her prostate specific antigen (PSA) levels (>4 ng/ml) are included. We excluded patients with PSA levels greater than 50ng/ml. as well as patients with less than 8 biopsy cores. The number of examined patients fulfilling the criteria was 474. An average age of them was 66.3 years (SD±8.3years). As an antibacterial prophylaxis, the patients were given fluoroquinolons in a dose of 500mg twice a day during a 3-day course of antibiotics, while the first dose was given one day before the procedure. In high risk patients, we used a single intramuscular dose of gentamycin 160mg right before the procedure followed by fluoroquinolons for the next five days.

Results: The most severe complication was vasovagal reaction, which occurred in 9 (1.9%) cases. Haematuria occurred in 122 (25.7%) cases up to 3 days and in 10 (2.1%) patients up to 7 days. Six patients (1.3%) required hospital admission for severe haematuria. Dysuria occurred in 71 patients (15%). Rectal bleeding occurred in 90 (19%) cases with an average 2 days of bleeding, from which 7 patients were admitted to hospital and administered haemostyptics. From the mentioned count. 2 (0.4%) patients underwent a rectal tamponade and one (0.2%) patient with arterial bleeding underwent an arterial ligation of a stricken artery. Haemospermia occurred in 71 (15%) cases. 23 (4.9%) patients suffered fever above 38°C. within whom in 7 (1.5%) cases was microscopicaly proven uri- nary tract infection requiring hospitalisation lasting 7 days on average. Sepsis occurred in 3 (0.6%) patients, symp- tomatic bacterial prostatitis in 6 (1.2%) cases and urinary retention occurred in one (0.2%) patient. There was not arty significant higher amount of complications in between 8-core and 10-core biopsy (P=0.26), not even in betwe- en 8-core and 12-core biopsy (P=0.32).

Conclusion: TRUS PB is a sale procedure with quite a low risk of complications. An important moment is a close monitoring right after the procedure. The most of the complications may persist for around two weeks and are trea- ted conservatively without persistent effects. Prophylaxis with broad spectrum antibiotics may provide an adequa- te coverage and lowers the risk of infectious complications.

Open access

M. Kocmálová, J. Ľupták, J. Barboríková, I. Kazimierová, M. Grendár and J. Šutovský

Abstract

Background: This study specified the role of several significant ion channels regulating the metabolism of calcium ions in contraction and relaxation of human detrusor muscle in order to identify possible target for future drugs that are capable of treating diseases resulting from impaired detrusor activity, e.g. overactive bladder. Although this disease can be successfully treated with muscarinic receptor antagonists or β3 agonist, many patients may not be suitable for chronic therapy, especially due to the relatively high side effects of the treatment.

Material and Methods: The study used the isolated detrusor tissue samples, which were obtained from the macroscopic healthy tissue of urinary bladder from 19 patients undergoing a total prostatectomy because of localized prostate cancer. Each biological sample was prepared into 8 strips. We used oxybutynin and mirabegron as control drugs and several blockers of specific subtypes calcium and potassium ion channels as tested substances. The contractility of bladder was investigated by an organ tissue bath method in vitro and contraction was induced by carbachol.

Results: The amplitude of contraction was successfully decreased by positive control drugs and, from tested agents, the comparable effect had the substance capable of influencing IP3 receptors and Orai-STIM channels and combination consisting of drugs possessing an inhibitory effect on IP3 receptors, L- and T-type voltage-gated calcium channels and Orai-STIM channels.

Conclusion: The present work represents a new finding about handling Ca2+ in urinary bladder contraction and pointed to a dominant role of IP3 receptor-mediated pathway in the regulation of Ca2+ metabolism, which may represent a future strategy in pharmacotherapy of impaired detrusor activity.